腹膜纤维化机制与治疗新进展

腹膜透析作为一种有效的肾脏替代治疗,在终末期肾病中运用日渐广泛,甚至成为肾脏替代治疗的首选方案。但长期的腹膜透析会导致腹膜功能下降、腹膜结构改变,最终演变成腹膜纤维化,甚至包裹性腹膜硬化症,使超滤失败,严重时使患者退出腹膜透析。目前国内外研究主要包括：上皮细胞一间充质转化、腹膜透析液的生物不相容性、血管紧张素一醛固酮系统、氧化应激、腹膜炎症、全身微炎症状态、基因调控、生长及转化因子等,针对上述发病机制,提出了相应的治疗方法。     

Mecanismos moleculares de los efectos benéficos de la alicina sobre la enfermedad cardiovascular

Cardiovascular diseases (CVD) include a group of diseases whose common denominator is the affection of the blood vessels, heart, and heart rate. The treatment of CVD represents high costs to the health systems and is focused on the control of risk factors. Despite the existence of a great variety of treatments of the CVD, these continue as the main cause of mortality mainly due to the multifactorial origin, and therefore more than one drug is required. In this context, allicin, a compound derived from garlic, has shown regulate the expression of signaling pathways and risk factors associated with the progression of CVD. Therefore, the objective of this work is to review the cellular and molecular mechanisms through which allicin exert its therapeutic effects and to describe the scientific evidences why allicin represents a potential candidate to assist in the treatment of CVD.     

Impact of cancer cell-intrinsic features on neutrophil behavior

Neutrophils are multifaceted innate immune cells that play a significant role in the progression of cancer by exerting both pro- and anti-tumorigenic functions. The crosstalk between cancer cells and neutrophils is complex and emerging evidence is pointing at cancer cell-intrinsic programs regulating neutrophil abundance, phenotype and function. Cancer cell-derived soluble mediators are key players in modulating the interaction with neutrophils. Here, we review how intrinsic features of cancer cells, including cancer cell genetics, epigenetics, signaling, and metabolism, manipulate neutrophil behavior and how to target these processes to impact cancer progression. A molecular understanding of cancer cell-intrinsic properties that shape the crosstalk with neutrophils will provide novel therapeutic strategies for personalized immunomodulation in cancer patients.     

Discourses on the Toxic Effects of Internal Chemical Contamination in Catalonia,Spain

Human exposure to and contamination by environmental toxic compounds generates discourses and practices that merit greater attention. In this article, we assess internal chemical contamination and the risk of toxic effects as an experience related to the production of meaning in everyday life. Drawing on the analysis of semantic networks of narratives from semi-structured interviews conducted with 43 informants in Catalonia, Spain, we consider participants’ perceptions of the health risks of toxic compounds, including social discourses on exposure, toxicity, and internal chemical contamination, and on responsibilities, consequences, and proposed strategies for controlling toxic compounds. Informants’ narratives on the relationships between nature and nurture suggest that they no longer perceive rigid boundaries separating the human body from the external environment and its chemical pollutants.     

伏立康唑潜在中毒浓度的危险因素研究

目的 探讨伏立康唑潜在中毒浓度的相关危险因素,以筛查其高危人群。方法 对2017年1月-2019年12月使用伏立康唑且监测其血药浓度的患者进行回顾性分析,将患者根据血药浓度值分为C_min ≤ 5.5 μg·mL^-1组和C_min> 5.5 μg·mL^-1组,采用单因素和Logistic多因素分析伏立康唑潜在中毒浓度的危险因素,应用ROC曲线对数值型危险因素作为预测因子的特异性、敏感性及临界值进行分析。结果 共纳入患者78例,其中33.33%(26例)患者的伏立康唑谷浓度>5.5 μg·mL^-1。单因素分析表明,伏立康唑潜在中毒浓度(>5.5 mg·L^-1)与性别、低蛋白血症、总胆红素和C反应蛋白(C-reactive protein,CRP)显著相关;多因素分析表明,高CRP是伏立康唑潜在中毒浓度的独立危险因素。ROC曲线分析显示,CRP>53 mg·L^-1的患者是发生伏立康唑潜在中毒浓度的高危人群。结论 对CRP>53 mg·L^-1的高危人群应密切监测伏立康唑血药浓度,以避免发生不良反应事件。     

Serum osmolal gap in clinical practice: usefulness and limitations

Background: Although serum osmolal gap can be a useful diagnostic tool, clinicians are not familiar with its use in clinical practice.

Objectives: The review presents in a series of questions-answers and under a clinical point of view the current data regarding the use of osmolal gap.

Discussion: The definition and the best formula used for the calculation of osmolal gap, the main causes of increased osmolal gap with or without increased anion gap metabolic acidosis, as well as the role of concurrent lactic acidosis or ketoacidosis are presented under a clinical point of view.

Conclusions: The calculation of osmolal gap is crucial in the differential diagnosis of many patients presenting in emergency departments with possible drug or substance overdose as well as in comatose hospitalized patients.     

麻杏调肺汤通过抑制炎症反应治疗慢性阻塞性肺病的探讨

目的:探讨麻杏调肺汤对慢性阻塞性肺病(COPD)的治疗效果,为后期的研究提供实验依据。方法:SD大鼠采用香烟烟雾暴露联合气管注射脂多糖(0.1 m L)法制造COPD大鼠模型,随机分为5组,分别为模型组,醋酸泼尼松组(3.3mg·kg~(-1)·d~(-1)),麻杏调肺汤低、中、高剂量组(1.7,3.4,6.8 g·kg~(-1)·d~(-1)),另设正常组,每组10只。待伤口愈合7 d后开始给药,连续5周;采用酶联免疫吸附测定(ELISA)法检测血清中肿瘤坏死因子-α(TNF-α),核转录因子-κB(NF-κB),白细胞介素-1β(IL~(-1)β),IL-8,IL~(-1)0;观察肺功能情况及肺病理组织学变化。结果:与正常组比较,模型组大鼠细胞因子TNF-α,NF-κB,IL~(-1)β,IL-8含量明显升高,IL~(-1)0含量明显降低(P0.01),肺部组织的病变明显,肺功能明显降低;与模型组比较,麻杏调肺汤高剂量组能明显降低大鼠细胞因子TNF-α,NF-κB,IL~(-1)β,IL-8,升高IL~(-1)0含量(P0.05,P0.01);减轻肺部组织的病变程度,改善肺功能。结论:麻杏调肺汤通过调节炎症反应中相关细胞因子TNF-α,NF-κB,IL~(-1)β,IL-8,IL~(-1)0治疗COPD模型大鼠,并对肺脏具有的保护作用。     

基于大鼠室性早搏心脏毒性的附子质量生物评价方法研究

附子是确有疗效的毒剧类中药,构建关联临床毒副反应的质量评价方法对提高其炮制减毒质控水平和保障临床安全性具有重要意义。该文针对附子可导致室性早搏这一早期心脏中毒反应,构建基于大鼠室性早搏(premature ventricular contractions,PVC)最小中毒量(minimal toxic dose,MTD)测定的附子炮制品质量生物评价方法,通过影响因素考察优化方法学(动物性别、体重、对照品稳定性与供试品稳定性),检测结果的重现性符合药品质量生物评价要求。应用该方法检测生附子及其不同炮制品黑顺片、白附片、蒸附片、刨附片、炮天雄致大鼠室性早搏MTD,结果表明,生附子炮制后MTD均显著升高(P0.05),其中黑顺片、蒸附片、刨附片与白附片的MTD分别为生附子的15.76,22.36,19.65,20.97倍;而炮天雄几乎无毒,用该方法检测不出MTD。该方法可以比较好的反映附子及其炮制品的整体心脏毒性。进一步结合附子炮制品的化学成分分析,发现炮制品中双酯型生物碱乌头碱、新乌头碱、次乌头碱,以及单酯型生物碱苯甲酰乌头原碱与PVC呈显著相关。此外,可能还存在其他与致心律失常相关的未测成分,值得深入研究。上述研究为附子临床早期心脏毒性评价与质量控制提供了整体、综合的方法,可作为化学评价方法的有益补充,为保障附子临床应用的安全性提供了新的方法。     

天然生物抗菌剂研究概况

目的：综述天然生物抗菌剂的研究进展。方法：结合国内外相关文献进行综合分析。结果：研究表明,天然抗菌剂主要有植物源、动物源、微生物源等抗菌剂,通过多种机制达到抑菌作用。结论：天然抗菌剂具有来源种类多,作用机制广等特点,具有良好的开发应用前景。